By Dr. Ali Madeeh Hashmi

“Qazwini wondered if Khwarizmi felt a sense of restlessness as he approached life’s end. Did his determinations and calculations about the universe no longer give him the sense of intellectual triumph that he once felt? Had he discovered that like the search for meaning in human existence, exactitude in sciences and mathematics was also an illusion?”
                    Musharraf Ali Farooqi-“The Merman and the Book of Power”


(Links to Part 1 & Part 2)

In 2006, I had been living in the USA for over 12 years and I was restless and bored. My original purpose for coming to America had long since been fulfilled. I had graduated King Edward Medical College in 1991 and, cynical and disillusioned with the medical education system in Pakistan and, to some extent, with Pakistan itself, I had come to America. Faisal sahib had not been encouraging about it; he had told me in no uncertain terms that he thought people who lived in America were self-centered and wealth obsessed, an opinion which, in retrospect, seems to have a grain of truth in it. He had encouraged me to think about going to England to pursue training in Medicine, his chosen subject. But I had no interest in becoming a physician specializing in Medicine. 

This was partly because of my experience with the subject in medical college. I had found it hard to understand and master. There were very few teachers in medical college like Faisal sahib who could both demonstrate the beauty of their chosen subject as well as inspire others to follow in their footsteps. And our fragmented, haphazard medical education system in King Edward had not helped. 

At KE, what I remember most vividly is a daily routine that appeared static and monotonous. We would show up for lectures at 8 or 8.30; hard enough in itself since I usually stayed up late studying for tests or reading. Getting up at 6 am to catch the college bus was torture. We would then have two or three lectures with most of our class, between 150 to 180 students (the actual class size had swelled to around 250) crammed in lecture halls on hard wooden benches with uncomfortable backrests, doodling on our note pads or scratching on the benches themselves. This was the era way before cell phones and other devices that students today can use to entertain themselves during boring lectures. We would have two to three lectures in succession during which we would be trying to alternately stay awake or hoping desperately for time to go faster so we could go to the canteen and eat something. If we were lucky, one of our favorite medical or surgical teachers (like Faisal sahib) would show up and we would enjoy the time spent listening to them. The rest of the lectures were spent in looking at our watches or at the clock on the lecture theatre wall willing it to go faster.

Eventually the class would end and, I remember vividly, my class fellows would disappear somewhere, not to be seen again. After our lectures, we were ostensibly supposed to go to the ‘Wards’, the departments in Mayo where we were all assigned. This is a routine that starts in third year of medical college where medical students are supposed to be gradually introduced to the ‘clinical’ side of medicine including contact with actual patients in the hospital. 

In actual practice, third year medical students are usually treated as an afterthought by hospital staff and fourth year students not much better. It does not help that most of the subjects being taught in the hospital are not being examined in third and fourth years of college which means we had zero incentive to go to the hospital or learn anything about those subjects. It was the same for the doctors working in the hospital both junior and senior. They know that the interest of 3rd and 4th year medical students in the ‘clinical’ subjects (like Medicine, Surgery etc.) is marginal since they are not ‘exam’ subjects. Little effort then, is made to engage these junior medical students in the Ward teaching and routine. 

In addition, the archaic ‘annual system’ of examinations at King Edward and most other medical colleges does not help. This system, a hangover from the colonial era, means that the subjects being studied are taught for a year and while some minor exams may happen during the course of the year, the preponderant weight of the assessment depends on the final exam at the end of the year. This naturally encourages little or no regular study during the first 8-9 months of the year, especially if, as in Pakistan, the students are younger, still in their teens or barely in their twenties and thus cognitively and emotionally still maturing. 

Around the 9th or 10th month of the year, all of a sudden we would realize that the final exams would soon be upon us leading to mad scramble to make schedules, start memorizing and doing ‘past papers’ (solving exam papers from past years to practice for the actual exams) etc. In addition, as our exams approached, our collective anxiety would start rising proportionately as we grappled with the huge amount of material which had been assigned for us to labor through and to which we had paid little or no attention throughout the year. 

In the late 1980s, while I was in medical college, student activism had almost died down after a ban had been imposed on student unions by General Zia’s military government in 1984. But some remnants of student union activity still persisted and at this time of the year, they were mainly directed towards trying to get exams postponed (ostensibly to allow more preparation time although in retrospect it seems rather ridiculous that we sat around doing nothing for most of the year and then agitated for more time to prepare!). Eventually what all this accomplished was that instead of graduating in the requisite five years, it took us six to finish medical college.

In 2006, when my wife and I, with our two young sons decided to come to Lahore, we were uncertain if we wanted to move back to Pakistan permanently. I had completed my education in the US, had been working for a few years and we were financially comfortable. 
But living abroad can be a poisoned chalice.

The only way, as someone once wrote, to be truly happy in a foreign land is to forget the land of your birth. But how can that be? I cannot speak for anyone else, but for me, every day in the US was a reminder of what I had left behind and a part of me longed to be back in Pakistan; a feeling shared by almost everyone who has lived abroad for any length of time. 

In addition, I had always wanted to teach and be around students and young people. In retrospect, perhaps my desire to mentor and teach young people was a way to undo the lack of mentoring I felt I had needed in KE. Medical students are brilliant, energetic, dedicated people. Anyone who has spent the better part of their young lives mastering complex scientific subjects, day in and day out for years and years, foregoing outings with friends, parties and all manner of idyllic youthful pursuits necessarily must have an unusual amount of drive and ambition. 

But once you are in medical college, the path forward becomes less clear and the idealistic halo dims. The main questions becomes “Now what?” For a while you can avoid the questions by making new friends and grappling with impossibly tough academic challenges but the question keeps resurfacing. And, of course, it is underpinned by the biggest challenge of all: growing up and learning to become an adult. I had felt this acutely in medical college and had, I now realized, longed for someone to show me the way; to help me explore my options for the future, encourage me to follow my dreams, help me stamp out my fears and help me grow up. This is what I had always wanted to do for others when I became a teacher.

So we sold our little starter home, the first house I had bought in my life, in which our two sons had been born and came to Lahore. My employers in Arkansas were rather mystified as to what I was up to, partly because I could not give them a good reason about why I was leaving. But to their credit, they understood that we wanted to spend time with our families and we parted on good terms.

Back in Lahore, I sought out a KE class fellow, now an eminent cardiac surgeon who suggested I go meet Faisal sahib and get his advice about what to do next. Ammar (now Professor Dr. Ammar Hameed Khan, professor of Cardiac Surgery) and I had met in college and even though we came of divergent back grounds (his father had been very close to Maulana Maudoodi and the family was, obviously, religiously conservative while I came from a family of leftist activists), we had bonded over a shared love of poetry and literature. Ammar was well versed in the poetry of Faiz, my grandfather, and, interestingly, used to recite Faiz (and other poets) while all of us crowded around the ‘cadavers’ (dead bodies) in the Anatomy department cutting and exploring their various organs. The pungent smell of formalin in the air (to preserve the dead bodies) and his recitation of poetry made for an odd but arresting mix which I still remember to this day

At any rate, he had worked with Faisal sahib in the years I had been away in America and was close to him (we had also done our ‘house job’ together with Faisal sahib at the same time in North Medical Ward in 1992). He took me to see Faisal sahib who by this time, had risen to the highest post in a new medical college he had helped establish: The Services Institute of Medical Sciences (SIMS). It was a brief meeting with Faisal sahib granting me an audience at the behest of Ammar. He may or may not have remembered who I was from years before but I do remember that he was non-committal about offering me any work, at SIMS or otherwise. By this time I was a psychiatrist and, I was to learn later, Faisal sahib had a healthy distrust of psychiatrists and psychiatry. He was not discouraging at that meeting but I came away empty handed. I did have the feeling though, that if I ended up staying in Lahore, he would not mind seeing me again.

As it happened, we stayed in Lahore for about four months and then, after some soul searching, headed back to Arkansas where my bemused former employers were happy to welcome me back.

...to be continued


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